Waiting periods

Limits

Inclusions

Restricted

Not restricted

Title

General dental services

Description - Long

• 100% of the cost of check-ups, up to two times per year and fissure sealings where the fees are within the range of usual, customary and reasonable charges
• Fixed benefits apply to additional check-ups and all other items
• Check-ups limited to an examination, fluoride, and scale and clean
• Examination items 011 to 017
• Fluoride treatment item 121
• Scale & clean items 111, 114 and 115

• Fixed benefits paid per item
• Orthodontics services to a lifetime limit of $1,250 accrued at $250 per year of membership
• 100% of the cost of orthodontic items up to accrued limit at the time of service

Combined limit of $1,600 with general dental services.

Waiting period

12 months

Total Limit

$1,600 combined limit

Restricted

Not restricted

Title

Optical

Description - Long

• $500 limit over any two consecutive calendar years i.e. claims made in the current and prior year cannot exceed $500
• No sub-limits apply
• Use the full $500 for your choice of frames, lenses or contact lenses
• 100% of the cost of optical appliances
• $50 for optical repairs - included in $500 optical limit

Waiting period

2 months

Total Limit

$500

Restricted

Not restricted

Title

Non-PBS pharmaceuticals

Description - Long

Prescribed medicines not featured on the Pharmaceuticals Benefits Scheme (PBS) and immunisations.

• 75% of the cost where the use of the item was prescribed by a registered health practitioner for a health condition (except hearing aids)
• One set of hearing aids every three calendar years
• One hearing aid: $200
• Two hearing aids: $400
• Hearing aid repairs: $50
• For Fund-approved consumable items, benefit paid twice per calendar year
• For Fund-approved non-consumable items, benefits paid once every two years